CN104135955A - Surgical device - Google Patents

Surgical device Download PDF

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Publication number
CN104135955A
CN104135955A CN201380011153.XA CN201380011153A CN104135955A CN 104135955 A CN104135955 A CN 104135955A CN 201380011153 A CN201380011153 A CN 201380011153A CN 104135955 A CN104135955 A CN 104135955A
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CN
China
Prior art keywords
mentioned
liquor charging
energy
output
pump
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Granted
Application number
CN201380011153.XA
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Chinese (zh)
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CN104135955B (en
Inventor
佐内秀男
八田信二
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Olympus Corp
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Olympus Medical Systems Corp
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Publication of CN104135955A publication Critical patent/CN104135955A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00026—Conductivity or impedance, e.g. of tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00684—Sensing and controlling the application of energy using lookup tables
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00744—Fluid flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00761—Duration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00994—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/007—Auxiliary appliance with irrigation system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation

Abstract

A surgical device (1) has: a treatment unit (31) for treating a biological tissue; an ultrasound output unit (43) and a high-frequency output unit (44) which generate energy for imparting ultrasonic vibrations or a high-frequency current to the treatment unit (31); a fluid-conveying tube (25) and a tube (21b) for conveying a fluid; an opening (21a) for conveying the fluid from the fluid-conveying tube (25) and the tube (21b) to between the biological tissue and the treatment unit (31), and positioned in the treatment unit (31); a pump (47) for supplying the fluid to the fluid-conveying tube (25) and the tube (21b); and a CPU (41). The CPU (41) controls the pump (47) in conjunction with the stoppage of the output of energy from the ultrasound output unit (43) and the high-frequency output unit (44), and in a manner such that after the stoppage of the output of the energy, the supply of the fluid from the pump (47) is conducted only in a prescribed amount or for a prescribed interval of time.

Description

Operation device
Technical field
The present invention relates to a kind of operation device, particularly relate to a kind of operation device that can carry out at least one output in ultrasonic vibration output and high frequency electric output.
Background technology
Surgery is used in operation with treatment apparatus and carries out the disposal such as the solidifying of bio-tissue, incision.The treatment apparatus (so-called shears shape type) of the type that surgery is disposed with treatment apparatus existence clamping bio-tissue.In addition, for example knownly in surgery use is put utensil a kind ofly can carry out the ultrasonic treatment apparatus of ultrasonic vibration output and the high-frequency treatment utensil that can carry out high frequency electric output, and, also knownly in recent years a kind ofly can carry out the energy treatment apparatus that ultrasonic vibration output and high frequency electric are exported simultaneously.
In the ultrasonic treatment apparatus of shears shape type, the parts of a side carry out ultrasonic vibration, and the jaw parts of opposite side open and close to clamp with respect to the parts of a side.In addition, in the high-frequency treatment utensil of shears shape type, carry out the bipolar output of high frequency electric with two parts.
This treatment apparatus is for example used in the sealing of blood vessel and cuts off and dispose.Surgeon closes the clamping part of shears shape and clamps blood vessel, connect the switch of the regulations such as foot switch, the part being held of blood vessel is heated and makes moisture evaporation, make thus bio-tissue solidify or cut bio-tissue, thereby can seal or cut off blood vessel.The clamping part that surgeon can open shears shape is observed the sealing state of blood vessel to confirm disposal state, leaves from clamping part according to blood vessel, can confirm the cut-out of blood vessel.
In United States Patent (USP) Publication US2010/085196A1 description, United States Patent (USP) Publication US2003/0040672A1 description and United States Patent (USP) Publication US2010/0324458A1 description, the operation device of disposing by high frequency output is disclosed for example.
But in the time using this energy treatment apparatus to carry out the disposal of solidifying or cutting of bio-tissue, the situation that the bio-tissue of the part of clamping adheres to disposal portion often occurs.
Conventionally the surface of two of disposal portion hold assemblies is applied to waterproof coating and prevent that bio-tissue from adhering to disposal portion.But the waterproof coating of disposal portion is peeled off in the time repeatedly disposing sometimes, be attached to the surface of disposal portion by the dirt causing such as burning, thereby cause bio-tissue to adhere to disposal portion.
In the time that bio-tissue adheres to disposal portion, surgeon cannot confirm to have disposed.Specifically, in the time that bio-tissue adheres to disposal portion, even if open the clamping part of shears shape, surgeon also cannot observe the disposal state of bio-tissue.In addition, in the time that bio-tissue adheres to disposal portion, cut blood vessel can not leave from clamping part, and therefore surgeon cannot confirm the cut-out of blood vessel.
And, also there is following situation: finish although cut to dispose, but blood vessel etc. do not leave from treatment apparatus because bio-tissue adheres to disposal portion, therefore surgeon thinks that cutting disposal does not finish and proceed output, thereby also has this problem of wearing and tearing of the pole plate of accelerating disposal portion.
In above-mentioned three United States Patent (USP) Publications, show no sign of and consider that in the time finishing for the energy output of disposing bio-tissue adheres to disposal portion and surgeon cannot confirm to dispose completes this problem.
The present application completes in view of the above problems, and object is to provide a kind of and prevents that in the time that the energy output being undertaken by ultrasonic vibration or high frequency electric finishes bio-tissue from adhering to the operation device of disposal portion.
Summary of the invention
According to a mode of the present invention, operation device has: disposal portion, and it is for disposing bio-tissue; Power generation portion, it produces the energy for above-mentioned disposal portion being applied to ultrasonic vibration or high frequency electric; Liquor charging pipeline, it is for sending liquid; Liquor charging mouth, it is arranged at above-mentioned disposal portion, for passing out to from the aforesaid liquid of above-mentioned liquor charging pipeline between above-mentioned bio-tissue and above-mentioned disposal portion; Pump, it is for offering aforesaid liquid above-mentioned liquor charging pipeline; And control part, it stops controlling linkedly said pump with the output of the above-mentioned energy from above-mentioned power generation portion, makes to provide aforesaid liquid stipulated time or the ormal weight from said pump after the output of above-mentioned energy stops.
Brief description of the drawings
Fig. 1 is the figure of the structure for the related operation device of the first embodiment of the present invention is described.
Fig. 2 is the block diagram that represents the structure of power subsystem 12 that the first embodiment of the present invention is related and liquor charging unit 13.
Fig. 3 is the figure that represents the related relation that is stored in impedance z in storage part 42, that detected by impedance detection portion 45 and liquor charging time T d of the first embodiment of the present invention.
Fig. 4 is the flow chart that represents the example of the processing of the related CPU 41 that US efferent 43, HF efferent 44 and pump drive division 46 are controlled of the first embodiment of the present invention.
Fig. 5 be the first embodiment of the present invention related for ultrasonic vibration output, high frequency electric output or ultrasonic vibration and high frequency electric time the output signal EOUT of output and the pump drive signal POUT of pump 47 sequential chart.
Fig. 6 is the figure of the structure for the related operation device 1A of the second embodiment of the present invention is described.
Fig. 7 is the flow chart that represents the example of the processing of the related CPU 41 that US efferent 43, HF efferent 44 and pump drive division 46 are controlled of the second embodiment of the present invention.
Fig. 8 be the second embodiment of the present invention related for ultrasonic vibration output, high frequency electric output or ultrasonic vibration and high frequency electric time output output signal EOUT, pump 47 pump drive signal POUT, emit the sequential chart of normal saline solution from peristome 21a.
Detailed description of the invention
According to embodiment, the present invention is described below.
(the first embodiment)
Fig. 1 is the figure of the structure for the related operation device of the first embodiment of the present invention is described.As shown in Figure 1, operation device 1 is configured to and comprises treatment apparatus 11, power subsystem 12 and liquor charging unit 13.
Treatment apparatus 11 for can output ultrasonic wave vibrational energy and high frequency electric energy at least one party's the surgery treatment apparatus of shears shape type.Treatment apparatus 11 be configured to there is disposal unit 21, handle unit 22, oscillator unit 23, signal cable 24 and liquid pushing tube 25.
Disposal unit 21 is made up of the disposal portion 31 for disposing bio-tissue and elongated sheath section 32.Disposal portion 31 has probe 31a and the movable member 31b as jaw parts.Sheath section 32 is cartridge, and its inside is penetrated with the spindle unit for opening and closing probe 31a, movable member 31b etc.Movable member 31b can with the movement that handle unit 22 is operated to caused spindle unit etc. correspondingly, be arranged at sheath section 32 front end Xiao32aWei Zhou center and rotate.Therefore, the leading section of probe 31a and movable member 31b are configured for clamping the clamping part of bio-tissue.
And, being provided with the peristome 21a for sending normal saline solution at the leading section of disposal unit 21, peristome 21a is connected with the pipe 21b running through in sheath section 32.Also be connected with liquid pushing tube 25 through the base end part of the pipe 21b in handle unit 22, liquid pushing tube 25 is communicated with pipe 21b.As described in hereinafter, treatment apparatus 11 is configured to as the normal saline solution of the liquid of sending from liquor charging unit 13 and can penetrates from peristome 21a with pipe 21b by liquid pushing tube 25.Therefore, liquid pushing tube 25 and pipe 21b are configured for sending the liquor charging pipeline of normal saline solution.
In addition, as shown in the dotted arrow a of Fig. 1, dispose peristome 21a and pipe 12b, make the retained part between probe 31a and the movable member 31b of disposal portion 31 send normal saline solution and the normal saline solution that can drip.Thus, peristome 21a is arranged at disposal portion 31, is for passing out to the liquor charging mouth between bio-tissue and disposal portion 31 from the normal saline solution as the pipe 21b of liquor charging pipeline.
Handle unit 22 has rotary knob 35 in the front of the main part 34 of tubular.Surgeon is by rotating rotary knob 35 around the axle of main part 34, can change disposal portion 31, movable member 31b is with respect to the position around axle of probe 31a.
At the base end part of main part 34, oscillator unit 23 is installed.Oscillator unit 23 is connected with probe 31a.The inside of oscillator unit 23 has ultrasonic oscillator (not shown), can make probe 31a carry out ultrasonic vibration.
Main part 34 has handle portion 36, and handle portion 36 comprises fixed handle 36a and can fixed handle 36b.Handle portion 36 is for clamping the operating grip of bio-tissue.Surgeon makes can fixed handle 36b to approach fixed handle 36a when operating, while closing handle portion 36, the movable member 31b of disposal portion 31 rotates around pin 32a, can between probe 31a and movable member 31b, clamp bio-tissue.
And, be provided with at main part 34 multiple switches 37 that output function is used.Therefore, surgeon can control handle portion 36 while operate, leading section and movable member 31b at the probe 31a by disposal portion 31 clamp under the state of bio-tissue, by the disposal of switch 37 being carried out export when making operation carries out based on ultrasonic vibration output, based on high frequency electric output or based on ultrasonic vibration and high frequency electric.
Power subsystem 12 is control device, as described in hereinafter, comprises control part, and the operation of switch 37 being carried out according to surgeon, to ultrasonic vibration output with high frequency electric is exported and liquor charging is controlled.
Liquor charging unit 13 is connected with power subsystem 12 by signal cable 14.In addition, the liquid pushing tube 25 that liquor charging unit 13 is used by liquor charging is connected with treatment apparatus 11, can send normal saline solution to treatment apparatus 11 from liquor charging unit 13.At this, the example of sending normal saline solution is described, but can send, human body is not had to influential other liquid yet.
Fig. 2 is the block diagram that represents the structure of power subsystem 12 and liquor charging unit 13.The control device of power subsystem 12 for the energy output for the treatment of apparatus 11 is controlled.Power subsystem 12 comprises as the guidance panel 40 of operating and setting portion, central processor (hereinafter referred to as CPU) 41, storage part 42, ultrasound wave efferent (hereinafter referred to as US efferent) 43, high frequency output portion (hereinafter referred to as HF efferent) 44 and impedance detection portion 45 as control part, wherein, the output of above-mentioned ultrasound wave efferent is for the driving signal of the drive vibrator unit 23 of ultrasonic vibration output, and the output of above-mentioned high frequency output portion is for the high-frequency current signal of high frequency electric output.
As mentioned above, when CPU 41 is to ultrasonic vibration output, high frequency electric output or ultrasonic vibration and high frequency electric, output is controlled.Carry out by CPU 41 control sequence that storage part 42 stores and carry out this control.
Storage part 42 comprises ROM for storing this control sequence, the RAM in working area during as performing a programme and for storing the rewritable nonvolatile memory etc. of information of liquor charging described later time.
US efferent 43, according to the ultrasound wave output control signal from CPU 41, will output to treatment apparatus 11 via signal cable 24 for the driving signal that makes probe 31a carry out ultrasonic vibration.
HF efferent 44 is according to the high frequency output control signal from CPU 41, will output to treatment apparatus 11 via signal cable 24 for the high-frequency current signal that disposal portion 31 is provided to bipolar high frequency output.
Therefore, US efferent 43 and HF efferent 44 are respectively power generation portion, produce the energy for disposal portion 31 being applied to ultrasonic vibration and high frequency electric.
The circuit of impedance detection portion 45 for detecting for the impedance of the bio-tissue between probe 31a and movable member 31b to being clamped in disposal portion 31., impedance detection portion 45 is to detecting for the impedance clamping between two hold assemblies of bio-tissue in disposal portion 31.Impedance detection portion 45 by and probe 31a and movable member 31b between the corresponding detection signal of impedance offer CPU 41.
In addition, CPU 41 is also inputted to the operation signal from switch 37.In addition,, at this, as described in below, by carrying out the instruction of energy output by surgeon's console switch 37, but the instruction of energy output also can be undertaken by foot switch etc.
Liquor charging unit 13 comprises pump drive division 46 and pump 47.Pump drive division 46 is according to exporting the drive circuit for the driving signal of driving pump 47 via the pump drive signal from CPU 41 of signal cable 14.Pump 47 is connected with not shown container, is driven according to the driving signal that carrys out self-pumping drive division 46, and the normal saline solution being stored in container is offered to pipe 25.The discharge ability of pump 47 is for example 20ml/min.
CPU 41, according to the operation signal from switch 37, controls US efferent 43 and HF efferent 44, and control pump drive division 46.
In storage part 42, preset and store the data of the liquor charging time of the normal saline solution of sending from pump 47 described later.
Fig. 3 is the figure that represents to be stored in the relation of the impedance z being detected by impedance detection portion 45 in storage part 42 and liquor charging time T d.To become mode large and that liquor charging time T d step ground is elongated along with impedance z, in storage part 42, preset and store the liquor charging time T d for impedance z.For example be stored in storage part 42 with the form of table data with the corresponding liquor charging time T of impedance z d.
In addition also can export according to ultrasonic vibration,, export when high frequency electric output or ultrasonic vibration and high frequency electric each kind of these three kinds of outputs and set liquor charging time T d.
And, also can set liquor charging time T d according to each kind for the treatment of apparatus 11, each disposal object or treatment apparatus 11 and each combination of disposing object.In this case, the information that CPU 41 reads the identifier (being ID) that is stored in the kind that is arranged at the expression treatment apparatus 11 in memorizer for the treatment of apparatus 11 etc. judges the kind for the treatment of apparatus 11.Surgeon is using before treatment apparatus 11, from be presented at the object such as liver parenchyma, blood vessel of guidance panel 40, selects to dispose object.
In the guidance panel 40 of power subsystem 12, surgeon etc. can be to setting change with the corresponding liquor charging time T of impedance z d.
The setting value of liquor charging time T d is different and different according to the ability of the specification for the treatment of apparatus 11, pump 47 etc.For example set difference according to the kind for the treatment of apparatus 11, output, have macro-energy output, little energy output.In the situation that energy output is large, liquor charging time T d is long, and in the situation that energy output is little, d is short for liquor charging time T.Thus, in storage part 42, set and the corresponding liquor charging time T d such as the specification for the treatment of apparatus 11.
, liquor charging time T d is set as to the following time: make disposal by utilizing energy and holding portion dry, bio-tissue becomes the required time of state of the probe 31a or the movable member 31b that do not adhere to disposal portion 31 containing enough moisture.
In addition, in Fig. 3, by liquor charging time T d be set as with respect to the value step of impedance z increase, but also can liquor charging time T d be set as increasing linearly with respect to the value of impedance z as shown in a chain-dotted line.
Fig. 4 is the flow chart that represents the example of the processing of the CPU41 that US efferent 43, HF efferent 44 and pump drive division 46 are controlled.Fig. 5 is the sequential chart of the output signal EOUT of output and the pump drive signal POUT of pump 47 for ultrasonic vibration output, high frequency electric output or ultrasonic vibration and high frequency electric time.
The processing of Fig. 4 is to be pressed and the processing carried out by CPU 41 when any energy output in output in having indicated ultrasonic vibration output, high frequency electric output or ultrasonic vibration and high frequency electric at switch 37.
In the time that switch 37 is pressed and receives the instruction of energy output, CPU 41 carries out indicated this energy output (S1).It is ultrasonic vibration output in the situation that at energy output, to specify or indicated output drives US efferent 43.It is high frequency electric output in the situation that at energy output, to specify or indicated output drives HF efferent 44.In the case of output in energy output is ultrasonic vibration and high frequency electric, to specify or indicated output drives respectively US efferent 43 and HF efferent 44.In Fig. 5, output signal EOUT becomes HIGH (height) at moment t1, starts to carry out energy output.
CPU 41 detects (S2) according to the detection signal of impedance detection portion 45 to the impedance z between probe 31a and movable member 31b.
Then, CPU 41 judges whether switch 37 is closed, whether energy output stops (S3), in the time that energy output does not stop (S3: "No"), processes and turns back to S1.In the time that energy output stops (S3: "Yes"), CPU 41 reads according to the impedance z detecting the liquor charging time T d (S4) being stored in storage part 42.For example, in Fig. 3, for example, in the time that impedance z is z1 (600 Ω), read the value (for example 2 seconds) of liquor charging time td1.
Pump drive signal POUT is outputed to pump drive division 46 by CPU 41, and driving pump 47 carries out liquor charging (S5).Its result, sends normal saline solution from the peristome 21a of the leading section of the sheath section 32 for the treatment of apparatus 11, to the normal saline solution that dripped by the retained part of the bio-tissue of probe 31a and movable member 31b clamping.Its result, the retained part of bio-tissue is because energy disposal is dried, but quilt is dripped normal saline solution and is started to become moistening.In Fig. 5, at moment t2, energy output stops and starting carrying out liquor charging.
CPU 41 judges whether console switch 37 in the time carrying out liquor charging and has indicated beginning energy output (S6).When starting (S6: "Yes") when energy output, CPU 41 stops exporting pump drive signal POUT to pump drive division 46, stops pump 47 and stops liquor charging (S7), processes and turns back to S1.That is, CPU 41, when power generation when instruction receiving after the output of energy stops US efferent 43 grades as power generation portion, stops pump 47, preferentially carries out surgeon's operation instruction.
In the time not starting energy output (S6: "No"), judge whether the time from starting liquor charging has passed through the liquor charging time T d (S8) reading.CPU 41 is in the time being instructed to stop energy output, and the counting of time started, judges according to this count value whether the time from starting liquor charging passed through the liquor charging time T d reading.While not passing through liquor charging time T d in the elapsed time from starting liquor charging (S8: "No"), process and turn back to S5, proceed liquor charging.
In the time that the elapsed time from starting liquor charging is passed through liquor charging time T d (S8: "Yes"), CPU 41 does not export pump drive signal POUT and stops liquor charging (S9), end process to pump drive division 46.In Fig. 5, in the moment, t3 stops liquor charging.
That is, stop control pump 47 linkedly as CPU 41 and the output of the energy from US efferent 43 grades as power generation portion of control part, make to provide the normal saline solution stipulated time of self-pumping 47 after the output of energy stops.Specifically, CPU 41 stops correspondingly starting driving pump 47 to provide the normal saline solution of self-pumping 47 with the output of energy, and controls and make to stop pump 47 after providing the normal saline solution stipulated time of self-pumping 47.
Its result, during the liquor charging time T d setting, carry out liquor charging, therefore make the holding portion of the bio-tissue of moisture evaporation drying by utilizing disposal that energy carries out containing enough moisture, thereby do not adhere to probe 31a or the movable member 31b of disposal portion 31.
In the time that in disposal process, the disposal part to bio-tissue is dripped normal saline solution, exist to dispose to be partly cooled and the elongated this problem of Deal with Time.But according to the operation device 1 of above-mentioned present embodiment, the normal saline solution that drips after disposing, therefore can not make Deal with Time elongated yet.
In addition, in the time that in disposal process, the disposal part to bio-tissue is dripped normal saline solution, the in the situation that of ultrasonic vibration, the temperature rise of normal saline solution, produces cavitation phenomenon sometimes.In the time that the disposal portion 31 for the treatment of apparatus 11 under the state that is producing cavitation phenomenon contacts the bio-tissue around disposing partly, likely because cavitation phenomenon damages normal bio-tissue.But according to the operation device 1 of above-mentioned present embodiment,, therefore there is not the problem of this cavitation phenomenon in the normal saline solution that drips after disposing yet.
As mentioned above, according to the operation device 1 of above-mentioned present embodiment, for disposing and dry bio-tissue by energy, and then it carries out liquor charging control so that it comprises moisture by normal saline solution after disposing, and therefore can prevent that bio-tissue adheres to disposal portion 31 in the time finishing for the energy output of disposing.
(the second embodiment)
In the above-described first embodiment, with stopping linkedly of energy output, CPU 41 driving pumps 47 and start to carry out liquor charging, but in the second embodiment, according to the operation of the clamping for disposal portion 31 in handle portion 36, mechanically press liquid pushing tube 25 or liquid pushing tube 21b limits liquor charging, in the time that this clamping operation is disengaged, start to carry out liquor charging.
Fig. 6 is the figure of the structure for the related operation device 1A of present embodiment is described.In Fig. 6, to the additional identical Reference numeral of the structural element identical with Fig. 1 and description thereof is omitted.
In operation device 1A, treatment apparatus 11A can have jut 51 by fixed handle 36b1, and in the time that handle portion 36A is closed, this jut 51 makes liquid pushing tube 21b distortion with liquid pushing tube 21b butt.In addition, be fixedly installed receiving-member 52 in fixed handle 36a, this receiving-member 52 receives the liquid pushing tube 21b being out of shape due to jut 51.
; when handle portion 36A be closed and can fixed handle 36b1 when moving by the direction shown in solid arrow b in Fig. 6; jut 51 is mechanically pressed into receiving-member 52 by liquid pushing tube 21b in fixed handle 36a, makes liquid pushing tube 21b distortion so that flow through the current of the normal saline solution of sending from pump 47 in liquid pushing tube 21b and stop.In the time that surgeon opens handle portion 36A, liquid pushing tube 21b is not subject to the power from jut 51, and normal saline solution flows through in liquid pushing tube 21b.
Therefore, jut 51 in handle portion 36A and receiving-member 52 are configured in the way of liquid pushing tube 21b, form following liquid and send limiting mechanism, according to for clamp in disposal portion 31 bio-tissue to operating grip can fixed handle 36b1 operation, limit the sending of liquid of flowing through liquid pushing tube 21b.
The structure of power subsystem 12 and liquor charging unit 13 is identical with the structure shown in Fig. 2.The content of the processing of CPU 41 is different from the processing of the first embodiment.
Fig. 7 is the flow chart that represents the example of the processing of the CPU41 that US efferent 43, HF efferent 44 and pump drive division 46 are controlled.In Fig. 7, the additional identical Reference numeral of the processing identical with Fig. 4 is described simply.The processing sequences of Fig. 7 etc. are different from Fig. 4.Fig. 8 be output signal EOUT, the pump 47 of output for ultrasonic vibration output, high frequency electric output or ultrasonic vibration and high frequency electric time pump drive signal POUT, emit the sequential chart of normal saline solution from peristome 21a.
In Fig. 7, when switch 37 is pressed and when the instruction of received energy output, CPU 41 carries out indicated this energy output (S1), then, pump drive signal POUT is outputed to pump drive division 46, driving pump 47 carries out liquor charging (S5).
In the time carrying out the instruction of energy output, handle portion 36A is closed, and therefore jut 51 makes liquid pushing tube 21b distortion, even therefore driving pump 47, flowing of the normal saline solution of sending from pump 47 is also stopped.In Fig. 8, output signal EOUT starts to export at moment t11, but does not bother to see me out out normal saline solution.
After S5, CPU 41 detects (S2) according to the detection signal of impedance detection portion 45 to the impedance between probe 31a and movable member 31b, then, judges whether energy output stops (S3).
In the time not indicating the stopping of energy output (S3: "No"), process and turn back to S1.Not pressing switch 37, when instruction the stopping of energy output (S3: "Yes"), CPU 41 reads with the impedance z detecting and is stored in accordingly the liquor charging time T d (S4) in storage part 42.
In the time that along with stopping of energy output, surgeon opens handle portion 36A, jut 51, not according to pressing liquid pushing tube 21b, therefore starts to carry out liquor charging.Its result, sends normal saline solution from the peristome 21a of the leading section of the sheath section 32 for the treatment of apparatus 11, to the normal saline solution that dripped by the retained part of the bio-tissue of probe 31a and movable member 31b clamping.In Fig. 8, export energy during TR during till from moment t11 to moment t12, stop the output of energy and start to carry out liquor charging at moment t12.
CPU 41 judges whether console switch 37 in the time carrying out liquor charging and has indicated the beginning (S6) of energy output, in the time starting to carry out energy output (S6: "Yes"), processes and turns back to S1.This also with the first embodiment similarly, be operation in order preferentially to carry out surgeon instruction.
In the time not starting energy output (S6: "No"), whether the time from energy output stops that judges has passed through the liquor charging time T d (S8) reading, while not passing through liquor charging time T d in the elapsed time from starting to carry out liquor charging (S8: "No"), processing turns back to S6, proceeds liquor charging.
When the elapsed time from starting to carry out liquor charging is during through liquor charging time T d (S8: "Yes"), CPU 41 does not export pump drive signal POUT to pump drive division 46, stops liquor charging (S9), end process.In Fig. 8, in the moment, t13 stops liquor charging.
Therefore, even if pass through present embodiment, also during the liquor charging time T d setting, carry out liquor charging, therefore make the holding portion of the bio-tissue dry by utilizing disposal that energy carries out containing enough moisture, thereby can not adhere to probe 31a or the movable member 31b of disposal portion 31.
As mentioned above, according to the operation device 1A of above-mentioned present embodiment, to disposing and dry bio-tissue by energy, and then it carries out liquor charging control so that it comprises moisture by normal saline solution after disposing, and therefore can prevent that bio-tissue adheres to disposal portion 31 in the time finishing for the energy output of disposing.
In addition, in above-mentioned example, the operation of switch 37 and the on-off action of handle portion 36A for energy output are independently, but also can switch be set at handle portion 36A, when by handle portion 36A can fixed handle 36b1 operation while carrying out closing switch, switch connection and the index signal of produce power output.For example, in Fig. 6, as recorded in parantheses, can be provided with the jut different from jut 51 53 by fixed handle 36b1, be provided with the switch 54 of being pressed by jut 53 at fixed handle 36a in the time closing handle portion 36A.
According to this structure, can be used in the operation of switch and the on-off action interlock of handle portion 36A of energy output.
As mentioned above, according to the operation device of the respective embodiments described above, for disposing and dry bio-tissue by energy, and then it carries out liquor charging control so that it comprises moisture by normal saline solution after disposing, and therefore can prevent that bio-tissue adheres to disposal portion 31 in the time finishing for the energy output of disposing.
The operation device of the respective embodiments described above is effective especially in disposing for hepatic parenchymal energy.In the hepatic parenchymal situation being enclosed in film, by burning etc. and bio-tissue adhere to treatment apparatus in the situation that, in the time peeling off treatment apparatus from bio-tissue, blood capillary is torn and produces and bleeds profusely under many circumstances.According to the operation device of the respective embodiments described above, in the time finishing for the energy output of disposing, under fluid drips, prevent that bio-tissue from adhering to disposal portion 31, therefore do not exist because blood capillary is torn bleeding profusely of causing.
In addition, the operation device of each embodiment not only can be applied to liver parenchyma, can also be applied to other internal organs such as blood vessel etc. and is effective.
(experimental result)
In above-mentioned two embodiments, be illustrated immediately to start carrying out liquor charging after surgeon indicates stopping of energy output.But, in applicant's experiment, confirm following situation: while starting to carry out liquor charging, do not there is the preventing effectiveness of adhesion when exceeded for 1 second after instruction the stopping of energy output after.Therefore, preferably during about a few msec to 0.5 second, start to carry out liquor charging.This be due to, if within these times, can make bio-tissue moisture content adhere to disposal portion 31 can prevent bio-tissue.
In addition, be 20ml/min in the output of pump 47, it is above and below 5 seconds that the liquor charging time was preferably for 0.5 second.
Applicant has also carried out the comparative experiments of the situation of dripping after above-mentioned energy output and the situation of not dripping.Experiment condition is: in the situation that ultrasound wave is exported, exporting the bipolar output, frequency 47kHz of 40W, the condition of vibration 80 μ m, hold 25N left and right is carried out the ultrasound wave output in 3 seconds to the carotid artery of pig.The adhesion of the disposal portion for the treatment of apparatus prevents that the coating of use is because the past is repeatedly used and peels off.
Under this condition, the situation of the situation to the normal saline solution that drips after energy output and the normal saline solution that do not drip has respectively been carried out the experiment of 5 times.In the situation that the pump that is 20ml/min by the ability of sending drove for 1 second after energy output stops, 5 times medium vessels does not all adhere to disposal portion.On the other hand, the in the situation that of not dripping normal saline solution after energy output stops, 5 times medium vessels all adheres to disposal portion.
(variation 1)
In above-mentioned two embodiments, after energy output finishes, carry out the liquor charging of stipulated time, but also can replace the stipulated time and will carry out the liquor charging of ormal weight.That is, can be also, thereby CPU 41 control pumps 47 make to dispose and dry bio-tissue does not adhere to the liquid of the ormal weight for the treatment of apparatus containing enough moisture by energy to send.
In this case, ormal weight is that the information of liquor charging amount is also stored in storage part 42, as above-mentioned two embodiments, is set as difference according to the impedance detecting.And surgeon can set change to the value that is stored in the liquor charging amount in this storage part 42.
(variation 2)
In above-mentioned two embodiments and above-mentioned variation 1, liquor charging time or liquor charging amount are for according to predefined time of impedance or amount, but also can in guidance panel 40, be set by surgeon liquor charging time or liquor charging amount, not how and this liquor charging time setting or the liquor charging of liquor charging amount tube impedance.
Thus, CPU 41 control pumps 47, make this liquor charging time of setting after energy output finishes or the liquor charging of liquor charging amount.
The present invention is not limited to above-mentioned embodiment, can in the scope that does not change aim of the present invention, carry out various changes, change etc.
The application is the application as basis for priority in the application numbers 61/636285 of U.S. Provisional Application taking on April 20th, 2012, and above-mentioned disclosure is incorporated in present specification, claim, accompanying drawing.

Claims (9)

1. an operation device, is characterized in that, has:
Disposal portion, it is for disposing bio-tissue;
Power generation portion, it produces the energy for above-mentioned disposal portion being applied to ultrasonic vibration or high frequency electric;
Liquor charging pipeline, it is for sending liquid;
Liquor charging mouth, it is arranged at above-mentioned disposal portion, for passing out to from the aforesaid liquid of above-mentioned liquor charging pipeline between above-mentioned bio-tissue and above-mentioned disposal portion;
Pump, it is for offering aforesaid liquid above-mentioned liquor charging pipeline; And
Control part, it stops controlling linkedly said pump with the output of the above-mentioned energy from above-mentioned power generation portion, makes to provide aforesaid liquid stipulated time or the ormal weight from said pump after the output of above-mentioned energy stops.
2. operation device according to claim 1, is characterized in that,
Afore mentioned rules time or afore mentioned rules amount are stored in storage part and can set change.
3. operation device according to claim 1, is characterized in that,
Also have impedance detection portion, this impedance detection portion is detected the impedance clamping in above-mentioned disposal portion between two hold assemblies of above-mentioned bio-tissue,
Afore mentioned rules time or afore mentioned rules amount are different and different according to the impedance detecting in above-mentioned impedance detection portion.
4. operation device according to claim 1, is characterized in that,
Afore mentioned rules time or afore mentioned rules amount are different and different according to disposing object.
5. operation device according to claim 1, is characterized in that,
When above-mentioned control part receives the generation instruction of the above-mentioned energy to above-mentioned power generation portion after the output of above-mentioned energy stops, said pump is stopped.
6. operation device according to claim 1, is characterized in that,
The output of above-mentioned control part based on above-mentioned energy stops and starting to drive said pump so that the aforesaid liquid from said pump to be provided, and controls and make after providing from aforesaid liquid afore mentioned rules time of said pump or afore mentioned rules amount, said pump to be stopped.
7. operation device according to claim 1, is characterized in that,
Also there is liquid and send limiting mechanism, this liquid is sent in the way that limiting mechanism is configured in above-mentioned liquor charging pipeline, according to the operation to operating grip for clamp above-mentioned bio-tissue in above-mentioned disposal portion, the sending of aforesaid liquid of above-mentioned liquor charging pipeline flow through in restriction.
8. operation device according to claim 2, is characterized in that,
The afore mentioned rules time is more than 0.5 second and below 5 seconds.
9. operation device according to claim 1, is characterized in that,
Energy, the energy of high frequency electric or the energy of ultrasonic vibration and high frequency electric that the above-mentioned energy that above-mentioned power generation portion produces is ultrasonic vibration.
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